社区干预对心肌梗死合并代谢综合征的影响

Research of coronary heart disease myocardial infarction complicated with metabolic syndrome in community intervention

目的对冠心病心肌梗死合并代谢综合征患者进行随访,并进行社区干预。方法符合国际糖尿病联盟颁布的代谢综合征诊断标准,同时确诊心肌梗死者入选本研究。入选对象共207例,其中有195例完成了2年随访,随访率为94.2%。对所有患者采取群体教育与个体指导,包括健康教育、运动锻炼、控制饮食、戒烟限酒等。部分确诊高血压、2型糖尿病患者给予降压、降糖药物治疗。所有入选患者均给予他汀类药物,同时进行冠心病的相应治疗。随访采用门诊、电话随访或住院随访诊治的形式,随访1年、2年,分别测定患者的血压、甘油三酯、体重指数、腰围、空腹血糖等指标的变化。随访终止于进入调查后的2年。计数资料用χ2检验,计量资料用t检验,采用SPSS13.0统计软件进行数据处理。结果随访2年后,SBP、DBP、甘油三酯、体重指数、体重、腰围较随访前明显降低,但SBP、DBP、腰围、甘油三酯等指标总体上未达标;完成随访的195例,吸烟人数较前明显下降,但有131例仍在吸烟。结论对冠心病心肌梗死合并代谢综合征患者实施的行为干预,在改善患者行为生活方式、控制血压、血糖、降低体重等方面有积极作用,但仍不达标。

Objective To study the influence of community intervention to coronary heart disease in patients with myocardial infarction complicated with metabolic syndrome. Methods Patients in line with the promulgation of the International Diabetes Federation diagnostic criteria for metabolic syndrome, and diagnosis of myocardial infarction, were selected for this study.A total of 207 were selected, including 195 who completed the 2-year follow-up rate was 94.2%. Education for all groups and individual patients to take guidance, including health education, exercise, diet, limit alcohol and smoking cessation.Part of the diagnosis of hypertension, type 2 diabetes were treated with antihypertensive, antidiabetic drug treatment. All patients were given statins, while the corresponding treatment for coronary heart disease. Use of outpatient follow-up, telephone follow-up or hospital follow-up treatment in the form of follow-up of 1 year, 2 years, were measured in patients with blood pressure, triglycerides, body mass index, waist circumference, fasting glucose and other indicators.Follow-up investigation into the termination in the year.Statistical analysis of count data using Xz test, measurement data with the t test, SPSS 13.0 statistical software for data processing. Results Follow-up after 2 years, SBP, DBP, triglycerides, body mass index, weight, waist circumference was signifi- cantly lower than the follow-up; but SBP, DBP, waist circumference, triglycerides and other indicators, the overall did not meet on; the completion of follow-up of 195 people, compared with the number of smokers was significantly decreased, but there were 131 people still smoking. Conclusion Implementing behavioral interventions to patients with myocardial infarction complicated with metabolic syndrome can improve patient behavioral lifestyle, control of blood pressure, blood sugar, reduce weight and so have a positive effect, but still not standard.